Individual provider Active NPI

Martin Lawrence Serene, FNP-BC

  • Family Nurse Practitioner
  • Columbia, TN
National Provider Identifier
1952947244
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26825 Issued in TN
Practice address
1222 Trotwood Ave Ste 503
Columbia, TN 38401-6422
Phone
(931) 490-7775
NPI assigned
Nov 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26825 TN Primary
Adult Medicine Physician 207QA0505X 26825 TN

Addresses

Primary practice location

1222 Trotwood Ave Ste 503
Columbia, TN 38401-6422

Mailing address

1222 Trotwood Ave Ste 503
Columbia, TN 38401-6422
Phone (931) 490-7775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200203001381 TN Practitioner - Nurse Practitioner 1456787837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maury Regional Medical Group, IncGroup PAC ID 7911810742, 119 clinicians

Practice addresses (Care Compare)

1224 N Trotwood Ave
Columbia, TN 38401-4802

1224 Trotwood Ave
Columbia, TN 38401-4802
Phone (931) 381-1111

854 W James Campbell
Suite 303
Columbia, TN 38401-4672

854 W James Campbell Blvd
Columbia, TN 38401-4672
Phone (931) 388-8779

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.45 of 100Reported as group
Quality
42.88
Promoting interoperability
77
Improvement activities
40
Cost
74.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26825TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Dennis MD PLLC CurrentSince Nov 23, 2019 Accepting new patients
Maury Regional Medical Group, Inc Family CurrentSince Apr 24, 2023 Accepting new patients
Maury Regional Hospital Marshall Medical Center CurrentSince Apr 24, 2023 Accepting new patients

Locations

854 W James M Campbell Blvd
Ste 303
Columbia, TN 38401
Phone (931) 388-8779

1222 Trotwood Ave
Ste 503
Columbia, TN 38401
Phone (931) 380-9166

2084 W Main St
Milan, TN 38358
Phone (731) 686-8321

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1952947244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 TROTWOOD AVE STE 503",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384016422",
            "telephone_number": "931-490-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 TROTWOOD AVE STE 503",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384016422",
            "telephone_number": "931-490-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERENE",
        "first_name": "MARTIN",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-21",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26825",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TN",
            "license": "26825",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.